COURSE  

NR-565: Advanced Pharmacology Fundamentals

Margaret is a 59-year-old Caucasian female who presents to the clinic for follow-up of her hypertension.  She reports that she has a worsening of a tremor in her hand over the last few months. She was seen by a neurologist previously and was diagnosed with an essential tremor but opted to not take medication because it wasn’t particularly bothersome.  … reports now that she has difficulty pouring a drink, drinking from a cup, using utensils to eat, and writing or drawing.  Margaret also reports that since you started her on Clonidine last month for her blood pressure, she has been having some difficulties with headaches, dizziness, dry mouth and difficulty urinating. You plan to discontinue the clonidine. 

Past Medical History: Hypertension, essential tremor and seasonal allergies.  

Surgical History: Tonsillectomy.  

Family History: Mother HTN & essential tremor, Father Diabetes, Sister Diabetes all deceased.  

Social History: Denies tobacco use, wine one to two glasses a week, denies recreational drugs, exercises twice a week.  

Allergies: NKA   

Current medications: Multivitamin with Iron 1 tab PO daily, Claritin 10mg daily PO prn for allergies, Clonidine 0.1mg PO BID   

All vaccines up to date.  

Vitals: Height 57 inches, Weight 145 pounds, BP 156/85, P 70, R 16.    

Physical exam is normal.

• What are your treatment goals for Margaret today?
• What is your pharmacological plan and rationale? (cite with appropriate clinical practice guidelines or scholarly peer-reviewed articles and always include medication name, strength, dosage form, route, frequency and duration when making recommendations)
• Pick one medication from your response above and list five patient-centered teaching points for the medication.

ANSWER  

What are your treatment goals for Margaret today?

The treatment plan for the patient is to replace her hypertension medication and discontinue clonidine

What is your pharmacological plan and rationale?

Alpha2 agonists are usually preferred as a second or third-line treatment choice for patients with mild hypertension. Clonidine should be used with extreme caution or avoided completely since it has a cognitive function effect on geriatric patients. Additionally, clonidine increases parasympathetic stimulation while decreasing heart rate, peripheral resistance, sympathetic tone, and renal resistance.…..please click the icon below to purchase the answer at $10